Obstetric performance of women aged over forty years

Abstract

Background: Advanced age and parity constitute two major factors in the outcome of pregnancy and labour management both in the developed and developing countries. Objective: To examine pregnancy outcomes in women aged 40 years and above with the view of proffering solution to some of the problems encountered. Design: A case control retrospective study. Setting: Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria from 1st January, 1995 to 31st December, 1999. Subjects: Three hundred and three women who delivered at 40 years of age or above. The control group comprised of 303 women who delivered between 20 and 29 years during the five years period. Main outcome measures: Gestational age at delivery, birth weight, mode and type of delivery, pregnancy and birth outcome. Results: This showed a significant increase in prematurity, low birth weight, medical complications, operative deliveries (Caesarean section, vacuum and forceps), birth asphyxia and perinatal deaths all at P<0.05. Conclusion: There is a poor pregnancy outcome at fourty years and above. Patients need to be counselled for care in a specialised centre.